I was asked by a friend to give her some info about vaccinations and what I did. These are my own feelings and my decision for my family, while I am a nurse they are not medical recommendations by anyone but me and what made sense to me. I share them as it is hard to find anything middle ground out there.
First it is impossible to find unbiased information on the internet, both the for or against will scare the bejezus out of you and leave you not knowing what to do. I spoke to my dad a GP for many years but when I was little he worked in a community hospital in one of the old homelands. He is now a Professor of Family Medicine and I trust his experience. He did not try to scare me into anything he said there are risks whatever you choose, you as the parent have to weight up the likelyhood of each risk and decide which ones you are willing to live with and which not. Every medication, injection etc that anyone takes ever has potential side effects and these are worse in some and not others and who is going to react and who is not in next to impossible to know before hand.
With that in mind I started at the top and and looked through the shots and the diseases and decided which ones to do. I will list them and my decisions below.
I did delayed vaccination for a number of reasons:
- I was breast feeding exclusively and so they would have my immunity to all these diseases until 6 month A babies immune system is very very immature and interestingly enough is only ever fully mature to the same level as an adult after 6 years old ( this is the reason that some extended breast feeders use to continue until their children are older, and while I totally understand that and feel everyone needs to breast feed to an age that is comfortable to them 4, 5 and 6 were just too old for me, I got to 2 with all of mine – but I digress)
- My kids did not go to day care or creche when they were young and so were not exposed to large groups of other children all the time where they might pick up stuff earlier.
- It just felt right.
- I started at 6 months ( except the TB but I cover that and the timing below) and then kept the time spacing recommended with the repeat vaccines as they build on each other. The only other timing I changed drastically was the TB but I will explain more below
What I did and what I didn’t
Vit K at birth: No – this is a long explanation and again one you have to consider carefully, if you want more of my thoughts on this ask and I am happy yo tell you all my reasoning. Here is an article from a Midwifery journal http://www.aims.org.uk/Journal/Vol13No2/vitk.htm
TB: Rachel and Titus have had TB but not Caleb, he was born in the UK where they don’t do it and when we got back I spoke to my dad and he said that she shot really only protects them from TB meningitis and the risk for this is more in those under 18 months and Caleb was over 18 months when I got back. I had a home birth and so it was not done at birth but I went to do it at the clinic later. I was worried that I had left Titus’s one a bit long as I only got there when he was 4 weeks old as The Geek’s sister had died just after Titus was born and we got wrapped up in funeral plans and stuff at the time. Later when I told my dad I was a bit stress for leaving it so long as it was always one of those that one was warned to do ASAP and is done in hospital. He explained that the reason is TB is so very very common in SA and that babies returning to townships with relatives that may be contagious need to be protected from birth. The efficacy of the TB vax is notoriously bad it protects about 80% against TB meningitus and about 60% against Pulmonary TB ( lung) most of us actually get herd immunity for living in a place with a high TB prevalence. Healthy immune systems just develop natural immunity. If I was to have another baby I would wait until 10 – 12 weeks for the TB shot ( NOT THAT I AM EVER HAVING MORE BABIES) you might have a bit of a fight in hospital as it is a standard jab but as a parent you have the final say as long as you make it clearly known you do not want it. But be very clear as there is stuff they just do by routine. The research http://www.ncbi.nlm.nih.gov/pubmed/19616494
chickenpox: no, it is not dangeous, I took the risk of some scars. The CP vax only lasts 10 years and so you have to repeat it every 10 years for the rest of your life or risk getting very very sick as an adult. Adult chicken pox can be very serious. For most children it is a mild irritation and maybe a slight higher irritation for the mom who has cranky kids but getting it offer a better immunity which is usually life long. The very very rare person get chicken pox twice in their life.
Polio: yes this is a debilitating disease which is still prevalent in SA and can be picked up from water that might have been contaminated further upstream ( fecal contamination), so unless your kid never ever swims in a river, pond, lake or any other outdoor natural water source they in my opinion need the polio vax.
Pertusis (whooping cough): not deadly and is a maybe one but it can damage lungs in sever cases and my sister is a serve asthmatic after getting it as a kid, she would always have been an asthmatic and she was vaccinated but she was just unlikey but it did damage her chest. The worst thing about this disease is that it is highly contagious and for a LONG time.I had a friend with kids who got it and she was housebound for 3 months. You have to wait a month after each child first shows signs before you can see other people. The whoop and vomiting in kids especially at night is very draning on the mom and in small babies they can stop breathing. Under 1 it is dangerous.
Diptheria – not common it is a skin and upper respiratory track illness which in and of itself is not too bad and can be mild BUT there is a 20% chance of myocarditis ( heart damage) and 10% of nerve damage which is 2 in 10 and 1 in 10 which are too high risk for me. Things that are 1 in 100 000 are a different story.
Tetanus: causes lock jaw to which there is no cure and most will die, you can get it from common things like a rusty nail so I did this one. You can wait for an exposure to a risk and then vaccinate but I did it from the beginning. It was included because people used to put cow manure on the umbilical cord before it fell off and so babies were exposed. It is also one that needs to be repeated every 5 years I think but most adults wait for an exposure ( the injection hurts like hell as an adult)
Hepatitis B: is actually quite difficult to get. What we used to know as Yellow jaundice it is still common in SA and can cause liver damage
haemophilus influenza: not actually a infulenza at all and not that dangerous in adults but can cause meningitis in babies
Rotavirus: I did not do this one, it is mostly for babies in day care and crèche where they are exposed, it causes a nasty diarrhoea which kids can dehydrate from easily but I felt with breast feeding and limited exposer I did not do this one. Those with babies going to day care and creche from young it is advised.
hepatitis A: did not, very rare in SA it is common in other places in Africa and if you travel consider doing it for the whole family before you go.
MMR: No, but not for the autism reasons. I will explain each disease separately. The autism link has been disproven but everyone needs to do their own research and make up their own mind on that one. This was not my reason at all
Measles: This might sound like a mild childhood disease, a rash and not feeling great and in many this is all that it is. BUT like diptheria while mild in many it has common complications as many as 20% of all case will get some of the more severe complications like pneumonia and menengitis. The wiki says Between the years 1987 and 2000, the case fatality rate across the United States was three measles-attributable deaths per 1000 cases this might not sound high but these are the death not just those than got very very sick. My dad said when he first started working out in the rural hospital their wards were full of children dying on measles, he said if he has seen any medical miracles in his 40 years as a Dr it was how in the space of the years they introduced the vaccine this number dropped away to next to none. He said it was the hugest case and effect of any health care preventative measure that he witnessed in his years as a Dr. Yes there is high mortality (death) in poorer lower economic groups with poorer nutrition but he said even as a GP in a affluent area later in his career he still saw measles causing nasty complications in healthy well nourished kids.
In SA they start the measles vax at 9 months and again at 18months, but all the research I could see was that they baby was well protected by the mother antibodies until 18 months and if you do it at 9 months the immunity is not very good and it has to be topped up at 18 months. I waited until between 18 month and 2 years and did one shot then for all my kids.
Mumps: Is a mild childhood disease with few life threatening risks. You just look like a chipmunk and have a face that hurts like hell. My reasons for vaccinating was against disease I felt there was a life threatening risk of. I did not feel that with mumps. I will never give it to Rachel as she is a girl and has no risk. I would ideally like the boys to get it and then their immunity is better but if neither of them has had it when they get to about 9 or 10 I will get them vaccinated. It can damage sperm if a teenage or adult man gets it and I want to be a Granny
Rubella: Again a mild disease but very dangerous to unborn babies if the mom gets it. Therefore women of childbearing age should have this in my mind. As a woman wanting to get pregnant or have more babies gets tested if you have antibodies great if not get the shot. I will tell Rachel the risks to her babies when she is older and advice that she gets it in her teenage years while I am around to remind her, but if she wants to wait and do it when she is older and has moved out then that is fine too.
I think that wraps up all of them, have I forgotten any? If you got this far well done. As I said in the beginning there are risks to everything and some kids react very badly to vaccinations and even have anaphylactic reaction but these are very rare. I thought the risk was worth taking for some of these diseases.
A note about Thimerosal, you might have heard that it is a mercury based preservative and that you can pay and get much more expensive vav without it and in the US it is being phased out.
Thimerosal is an antiseptic and antifungal agent that is used to help preserve the vaccinations. In the past there were cases where children died from infections from vaccinations that lacked preservatives. Unlike some other preservatives it does not reduce the potency of the vaccines that it preserves.
The concern is that, Thimerosal is a mercury compound. The risk were however based on a substance called methymercury and cause Thiomersal to be removed from childhood vaccination in the US starting in 1999. Since then this been found to be eliminated from the body and the brain significantly faster than methylmercury . The late-1990s risk assessments turned out to be overly conservative.
Preservatives like thiomersal are not needed in the more expensive single dose injectable which are available at a private clinic. Yet the World Health Organization has concluded that there is no evidence of toxicity from thiomersal in vaccines and no reason on safety grounds to change to more-expensive single-dose vax. Government vaccinations in South Africa do contain small doses of Thiomersal but after extensive research there is no proof that the more expensive vaccines are needed. But due to world wide pressure and the bad name it has in the general population it will probably be phased out in time. Which one you decide to use is again up to you.